​King Louis XIV (1638 –1715) was a famous king of France. In the year 1685, when he was at the height of his reign, his butt started to hurt. A lot. His royal physicians tried all kinds of treatments, trying to shrink the swelling, but finally, after months of suffering on everyone’s part, they called for a surgeon. This was a big deal.

Surgeons at the time were not considered respectable. They ranked many notches below physicians, on the level of barbers (in fact, mostwerebarbers). The Church forbade doctors to cut into a living body. But the king and his physicians were desperate.

His butt problem was diagnosed as something called an anal fistula. If you think it sounds bad, you’re right. It’s a condition where a new channel opens up leading from the bowel to the outside of the body, but that is not the anus—the channel through which waste issupposedto leave the body. We won’t speculate as to how the king developed his fistula, although we do know that the king ate enormous quantities of food, and his diet was probably not what we would consider healthy today. Also, his hygiene was not good. He often ordered windows to be opened when he entered a room, so that his courtiers would not be overcome by his smell.

The surgeon, Charles Francois Félix de Tassy, requested to wait six months before operating. He practiced on a bunch of peasants, none of whom actually had anal fistulae. Some of them even died.

The king’s fistula operation was performed on November 18th 1686. Sources reported that the king was calm. The surgeon was not. Félix had designed a “royally curved” scalpel especially for that purpose, inserting it into the fistula with the help of a retractor.

The operation was a success. The king was sitting up in bed within a month. It became fashionable for courtiers to admit they had a fistula, too, in hopes of being able to walk around Versailles with their butts swaddled like the king’s.

Why is this story important? By operating successfully on the king, Félix raised the profession of surgery to a more prestigious level. Félix was knighted and given money and land. But he was said to be so traumatized that he never again touched a scalpel.​(c) Sarah Albee 2014

Here’s the king, back in the saddle

​Sarah Albee's latest book is Poison: Deadly Deeds, Perilous Professions and Murderous Medicines. You can read a review that gives you a dose of what's in this book.

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